REPUBLIC OF SOUTH AFRICA
THE HUMAN RIGHTS COUNCIL RESOLUTION 26/20 ON: “THE RIGHTS OF
PERSONS WITH DISABILITIES TO SOCIAL PROTECTION”
SPECIAL RAPPORTEUR QUESTIONNAIRE TO STATES PARTIES
_____________________________________________________
RESPONSE FROM THE GOVERNMENT OF SOUTH AFRICA
MAY 2015
INTRODUCTION
The response of the South African Government to the right of persons with disabilities
to social protection must be understood within the context of South Africa’s transition
from a past characterised by state-enforced discrimination, exclusion and inequity.
This divisive, state-driven social engineering (apartheid) relegated the majority of the
country’s people to the fringes of the body politic and the economy and it distanced
them – almost entirely – from access to developmental resources. The systematic
marginalisation of persons with disabilities in South Africa resulted in unprecedented
levels of social, economic and cultural deprivation of access to the labour market in
pursuit for transformation to promote the inclusiveness agenda.
In South Africa, the period from 1994 to 2004 produced legislation, policies,
interventions, and programmes that were formulated with the aim of influencing the
environment for addressing equity goals over the medium to long term and also for
addressing immediate goals in increasing the number of persons with disabilities with
access to government services.
National legislation on employment equity, social security, etc. ensures an
environment conducive to full and equal participation of men, women and children with
disabilities in society, including equal access to opportunities, accessibility and
protection of the inherent dignity of the person. It is also consistent with Chapter 2,
subsection 9 of the Constitution of the Republic of South Africa, which specifically
prohibits discrimination on the basis of disability: - “(3) The State many not unfairly
discriminate directly or indirectly against anyone on one or more grounds, including
race, gender, sex, pregnancy, marital status, ethnic or social origin, colour, sexual
orientation, age, disability, religion, conscience, belief, culture, language and birth. (4)
No persons may unfairly discriminate directly or indirectly against anyone on one or
more grounds in terms of subsection (3). National legislation must be enacted to
prevent or prohibit unfair discrimination”.
Disability statistics have been a contentious issue around the world. The lack of
adequate, reliable, relevant and recent information on the nature and prevalence of
disability in South Africa remains a challenge. A further challenge has been differing
definitions of disability, with many being restricted or regarded it as discriminatory to
describe a person as being disabled.
Due to misreporting on the general health and functioning of children younger than five
years, data on this variable profiled only person five years and older. Questions on
disability were replaced by general health and functioning questions, and due to a
change in the questions, 2011 census results cannot be compared with the previous
censuses in 1996 and 2001.
The government’s commitment to the rights of persons with disabilities is demonstrated
by the establishment of the Disability Programme within the former Reconstruction and
Development Programme (RDP); self-representation by persons with disabilities in
Parliament, provincial legislatures and municipal councils; human rights instruments
such as the South African Human Rights Commission (SAHRC), the Commission for
Gender Equality and the Public Service Commission; development agencies such as
the National Youth Development Agency; the release of the White Paper on an
Integrated National Disability Strategy (INDS) in 1997, which was developed through
a process of broad consultation applying the UN Standard Rules on the Equalisation
of Opportunities for Persons with Disabilities; and the South African Disability Rights
Charter
Internationally, since the advent of democracy in 1994, South Africa has systematically
expanded its participation in leading the global agenda in the campaign for, and
eventual development of, the UN Convention on the Rights of Person with Disabilities
(CRPD) which, in its final format, embodies the principles of the South African process
set in motion in 1994 to advance the progressive realisation of the rights of persons
with disabilities as equal citizens. Implementation of the CRPD in South Africa
therefore commenced in 1994, when the Convention was officially ratified by South
Africa and came into force in May 2008.
The following is South Africa’s response to questions posed by the Special Rapporteur
of the Office of the High Commissioner for Human Rights Council.
LEGAL FRAMEWORK
This part of the questionnaire aims to determine information in relation to the
existence of legislation and policies concerning mainstream and/or specific
social protection programmes with regard to persons with disabilities.
Institutional framework/National instruments
1.
PROVIDE INFORMATION IN RELATION TO THE EXISTENCE OF
LEGISLATION AND POLICIES CONCERNING MAINSTREAM AND/OR
SPECIFIC SOCIAL PROTECTION PROGRAMMES WITH REGARD TO
PERSONS WITH DISABILITIES
a
In health matters:
(i)
The Constitution of the Republic of South Africa, 1996, provides that everyone is
equal before the law and has equal protection and benefit of the law. It prohibits
discrimination on a number of grounds, including disability.
The National Development Plan envisages a country which by 2030 has
eliminated poverty and has reduced inequality. The NDP 2030 acknowledges
that many persons with disabilities (PWDs) are not able to develop to their full
potential due to a range of barriers, resulting in their often being viewed as
unproductive and a burden.
The Promotion of Equality and Prevention of Unfair Discrimination Act, 2000 (Act
4 of 2000), gives effect to section 9 of the Constitution: to prevent and prohibit
unfair discrimination and harassment; to promote equality and eliminate unfair
discrimination; and to prevent and prohibit hate speech. It mandates the removal
of barriers and taking positive steps to ensure that PWDs are able to enjoy full
and equal participation and access to opportunities.
The National Health Act, 2003 (Act 61 of 2003), provides for the provision of
quality health services to the population of South Africa. The Act also provides
for the establishment of the National Health Council, which is a structure
responsible for making health policy in the country. It further gives the Minister
of Health the authority to make regulations on any health matter, including
regulations on rehabilitation and assistive devices.
The Mental Health Care Act, 2002 (Act 17 of 2002), provides a framework for the
provision of mental healthcare services in South Africa. Among other things, it
enables the establishment of observation services for 72 hours in non-mental
health facilities. It further provides a framework for the designation of mental
health facilities and establishment of mental health review boards.
Other instruments such as the Road Accident Fund Act, 1996 (Act 56 of 1996),
the Social Assistance Act, 2004 (Act 13 of 2004), the Road Accident Fund
(ii)
(iii)
(iv)
(v)
(vi)
Amendment Act, 2005 (Act 19 of 2005), and the Children’s Act, 2005 (Act No.
38 of 2005), promote and protect the rights of PWDs within different sectors.
b
One of the objectives of South Africa's Policy Framework on Disability is to
”recognize and accept their vital role in implementing all policies, programmes
and projects which address the needs of people with disabilities and their families
or caregivers, in line with disability-specific indicators". To be able to respond
effectively to the requirements of the national policy framework, it is imperative
to develop a policy framework that directly speaks to the needs of PWDs within
the local government sector.
The baseline study on disability mainstreaming in local government undertaken
in 2007 by the Department of Provincial and Local Government reveals that most
local government policy documents give little or no attention to disability
concerns, and in rare instances where disability is mentioned, it is expressed in
generic terms and as part of the broad categorization of "designated groups" or
"the poor".
The finding corroborates those of the Public Service Commission reports
published in 2004 and 2007, which indicated that there were still challenges
facing the Public Service in deepening disability equity. The baseline study
underlined the urgency of developing the local government policy framework on
disability.
i.
This framework is intended to provide an enabling environment for municipalities,
provincial local government departments and other role players in the local
government sphere to address disability issues. It seeks, among other aims, to
provide guidance on the implementation of the National Disability Policy and
other policy and legislative instruments that seek to promote the rights and
freedoms of PWDs within the local government context. It also proposes
implementation structures and mechanisms for the coordination of disability
issues and monitoring.
ii.
The framework further advocates the mainstreaming of disability into the local
government agenda. This means that disability issues should be made an
integral part of local government conceptualization of projects, planning and
implementation within the parameters of the five Key Performance Areas (KPAs)
for local government.
iii.
In the application of the policy framework, it should always be borne in mind that
in some instances special or additional measures/interventions might be
necessary to address the needs of categories of people who are most
vulnerable. This includes women and children with disabilities and PWDs living
in rural areas.
This framework acknowledges various disability terms such as 'disabled people',
'physically challenged', 'handicapped', 'differently abled' and others, but for
purposes of this framework, the term 'people with disabilities' (PWDs) will be
adopted.
1.1
Institutional framework in charge of its implementation
a.
People with Disabilities in the Public Service
•
Handbook on Reasonable Accommodation for People with Disabilities in the
Public Service, 2007 - the handbook is part of the JobACCESS Resource Kit for
recruitment, employment and retention of PWDs in the Public Service. It provides
guidelines on how departments can provide reasonable accommodation as part
of the organization’s operational requirements rather than as a special action.
•
JobACCESS Strategy for the Appointment, Recruitment and Retention of People
with Disabilities and its Implementation Guide, 2009 - This is a tool intended to
assist departments with steps to follow in order to remove and eradicate barriers
that exist in the employment of PWDs. The ultimate aim is to ensure that all
PWDs in the Public Service, irrespective of race, sex, or creed, are provided with
equal opportunities for employment.
•
These two documents have now been strengthened by a Policy on Reasonable
Accommodation and Assistive Devices for the Public Service.
•
The Policy is also intended to assist a systematic and consistent approach to:
budgeting and costing for special needs; the acquisition, disposal, repair and
maintenance of assistive devices; clarifying roles and responsibilities of the
different role players in the provision of assistive devices; provision of
transportation for employees with disabilities; provision of personal assistance
and evacuation chairs; reporting requirements and monitoring and evaluation of
the policy.
•
The Department of Public Service and Administration (DPSA) has developed the
following redress mechanisms to implement the objectives of the various Acts
and policies in the Public Service:
•
The Public Service Act, 1994 (Act 103 of 1994), provides for the organization
and administration of the Public Service and the regulation of conditions of
service. Transformatory conditions of service such as maternity benefits, salaries
and pensions are some of those that have been made possible through this Act.
•
White Paper on the Transformation of the Public Service of 1995 identified
a need to “create a genuinely representative public service which reflects the
major characteristics of South African demography, without eroding efficiency
and competence.” This was translated by the commitment made by the
Government of National Unity to “continually improve the lives of the people of
South Africa through a transformed public service which is representative,
coherent, transparent, efficient, effective, accountable and responsive to the
needs of all” (WPTPS 1995: 6).
•
The purpose of the White Paper on Transforming Public Service Delivery of
1997 purpose was to provide a policy framework and a practical implementation
strategy for the transformation of public service delivery with a guiding principle
of the public service in South Africa to be that of service to the people (Batho
Pele).
•
The White Paper on Human Resource Management in the Public Service of
1997 introduced a shift from personnel administration to human resource
management and set the policy framework for managerial autonomy in terms of
managing human resources effectively and strategically as part of the wider
transformation agenda.
•
The White Paper on Affirmative Action of 1998 became the Government’s
commitment to the transformation of the Public Service into an institution whose
employment practices are underpinned by equity. The White Paper called for a
Public Service that was representative and drew on the talents and skills of the
diverse spectrum of South African society, and was geared not only towards
providing better services for all sectors of our society but also to enjoying
legitimacy in the eyes of South African people (1998:5). [Section (ii)(2) –
inculcate in the Public Service a culture which values diversity and supports the
affirmation of those who have previously been treated unfairly and
disadvantaged.] The core principle for affirmative action was that affirmative
action programmes must be integrated with other human resource management
and development practices, especially the management of diversity (1988:12)
b.
South Africa has established an agency called the South African Social Security
Agency (SASSA), which is an implementation arm for the Department of Social
Development (DSD).
c.
Access to Health Care
(i)
Standardisation of Provision of Assistive Devices in South Africa - A guide for
use in the Public Health Sector
For PWDs an assistive device promotes a normal lifestyle, improves their quality
of life and enhances the prospects of employment, education and participation.
It reduces the cost of care and dependency. Devices also reduce the extent of
hospitalisation and the demand for hospitalisation, and therefore liberate scarce
resources for other uses. The general availability of devices has been proven to
promote the dignity of PWDs and transform attitudes towards them. This
guideline puts forward proposals that will have direct practical benefit for PWDs
with due consideration of cost implications for the State.
National Rehabilitation Policy, 2000
The goal of this policy is to improve accessibility to all rehabilitation services in
order to facilitate the realization of every citizen’s constitutional right to have
access to health care services. This policy should serve as a vehicle to bring
about equalisation of opportunities and to enhance human rights for PWDs,
thereby addressing issues of poverty and disparate socio-economic
circumstances.
Framework and Strategy for Disability and Rehabilitation Services in South Africa
2015-2020 (Draft)
This strategy seeks to:
•
Integrate comprehensive disability and rehabilitation services, also within
priority health programmes from primary to tertiary and specialised health
care levels as guided by the document on Integrated Disability
Management and Rehabilitation Pathways of Care.
(ii)
(iii)
•
•
•
•
•
•
•
Develop an appropriate, effective and efficient referral system between all
levels of care, including the expansion of services to improve access to
rehabilitation units and specialised rehabilitation centres.
Foster inter-sectoral collaboration to address social determinants.
Implement accessibility standards for infrastructure, communication,
signage and information.
Increase awareness and knowledge of health care workers to change their
attitudes toward children and adults with disabilities and their families.
Improve monitoring and evaluation of disability and rehabilitation services.
Improve human resources for disability and rehabilitation services.
Improve access to appropriate assistive technology and accessories.
1.2
Legislative, administrative, judiciary and/or other measures aiming to
ensure access of persons with disabilities to mainstream social protection
programmes (e.g. poverty reduction, social insurance, health care, public
work, housing)
a.
Handbook on Reasonable Accommodation for People with Disabilities in the
Public Service, 2007 - the handbook is part of the JobACCESS Resource Kit for
recruitment, employment and retention of persons with disabilities in the Public
Service. It provides guidelines on how departments can provide reasonable
accommodation as part of the organization’s operational requirements rather
than as a special action.
Social grants are provided in compliance with various institutional frameworks
and legislation. These are: Constitution of the Republic of South Africa (1996)
section 27(1), Social Assistance Act, 2004, and its Regulations of 2008, the
White Paper on the Integrated National Disability Strategy (1997), the Children’s
Act, 2005 and the Children’s Amendment Act, 2007, and the Promotion of
Equality and Prevention of Unfair Discrimination Act, 2000.
b.
1.3
Creation of disability-specific programmes (such as disability pensions,
mobility grants or others)
a.
With the JobACCESS Strategy for the Appointment, Recruitment and Retention
of People with Disabilities and its Implementation Guide, 2009, a tool that intends
to assist departments with steps to follow in order to remove and eradicate
barriers that exist in the employment of PWDs. The ultimate aim is to ensure that
all PWDs in the Public Service, irrespective of race, sex, or creed, are provided
with equal opportunities for employment. These two documents have been
strengthened by a Policy on Reasonable Accommodation and Assistive Devices
for the Public Service.
Social assistance grants that are disability specific are the Disability Grants for
adults and Care Dependency Grants for children with disabilities.
b.
1.4
Fiscal adjustments or other similar measures
a
The Policy on Reasonable Accommodation and Assistive Devices for the Public
Service is also intended to assist a systematic and consistent approach to:
budgeting and costing for special needs; the acquisition, disposal, repair and
maintenance of assistive devices; clarifying roles and responsibilities of the
different role players in the provision of assistive devices; provision of
transportation for employees with disabilities; provision of personal assistance
and evacuation chairs; reporting requirements and monitoring and evaluation of
the policy. The policy has a costing model that should assist departments to
budget for reasonable accommodation.
•
b
The DPSA has developed the following redress mechanism to implement
the objectives of the various Acts and policies in the Public Service: The
Public Service Act, 1994, provides for the organization and administration
of the Public Service and the regulation of conditions of service.
Transformatory conditions of service such as maternity benefits, salaries
and pensions are some of those that have been made possible through
this Act.
The values of social assistance grants are increased annually in line with inflation
rate.
Implementation, Monitoring and Evaluation
2.
PROVIDE INFORMATION ON HOW PERSONS WITH DISABILITIES ARE
CONSULTED
AND
ACTIVELY
INVOLVED
IN
THE
DESIGN,
IMPLEMENTATION AND MONITORING OF SOCIAL PROTECTION
PROGRAMMES.
a
The Department of Social Development (DSD) is mandated to consult civil
society on designing, implementing, monitoring and evaluation of programmes.
The DSD holds consultations with the disability sector, including relevant
stakeholders as needed. Consultations were held with civil society on the design
and development of disability assessment tools, amendment of the definition of
disability, progress made on the approval and implementation of the assessment
tools, and the content and application of the assessment tools.
The DSD also hosts the National Disability Rights Machinery meetings
comprising the disability sector and all spheres of government.
In addition to above, the DSD established the Ministerial Committee on Disability.
(The Committee was established to advise the Minister on social services and
programmes for PWDs.)
b.
In health-related matters, the opportunity to develop the rehabilitation policy was
seized only in 1996 when the Directorate: Chronic Diseases, Disabilities and
Geriatrics was instituted in the national Department of Health. The subdirectorate
for disabilities (and rehabilitation) in this Department became fully operational
only at the end of 1996. At the beginning of 1997 the Subdirectorate: Disabilities
(and Rehabilitation) initiated a process to develop a national rehabilitation policy.
The Department subsequently appointed a technical committee responsible for
policy development. This committee comprised members from a broad spectrum
of stakeholders, including government departments, professional associations,
disabled people’s organisations (DPOs), non-governmental organisations
(NGOs), the disability rights movement and the private sector. Some 25 people
were directly involved in the technical committee, with many more consulted on
an ad-hoc basis.
The technical committee met three times in 1997 and managed to compile a
detailed situation analysis and identify major policy areas. The committee was
subsequently divided into task groups that focused on specific areas of policy
development. It held its last meeting at the end of March 1998, and made
provision for further consultation. This policy is a product of that exercise and
was negotiated with the relevant stakeholders before being finalised.
c.
At provincial and local government level the involvement of PWDs is done
through consultations on the planning or design of programme implementation
at local municipality level. Reporting is done at the same level of each
municipality.
d.
The Department of Public Works has established and launched a Disability
Advisory Council, comprising a number of national disability organisations, to
advise the Minister and Director-General on disability issues and monitor
disability mainstreaming in the Department's programmes.
3.
PROVIDE INFORMATION IN RELATION TO DIFFICULTIES AND GOOD
PRACTICES ON THE DESIGN, IMPLEMENTATION AND MONITORING OF
MAINSTREAM AND/O SPECIFIC SOCIAL PROTECTION PROGRAMME
WITH REGARD TO PERSONS WITH DISABILITIES, INCLUDING:
a
Challenges experienced in implementing rehabilitation services in South Africa
are related to a variety of factors. These include:
•
•
•
•
•
A medical model resulting in poor access to a comprehensive disability and
rehabilitation service, especially to persons in rural and disadvantaged
areas.
The implementation of disability and rehabilitation services as a vertical
programme with little or no scope for integration with priority health
programmes, such as Non-Communicable Diseases, Maternal Child and
Women’s Health (MCWH), HIV and Aids.
Inadequate follow-up due to a lack of clarity on referral pathways as well
as poor availability of services. This problem is aggravated by the fact that
there inadequate rehabilitation units in district hospitals and only two
specialised rehabilitation centres in the country. There is also poor
communication and coordination between service levels.
Inaccessible and unaffordable transport. Families of PWDs incur
significant costs for public transport and car hire in order to access health
care. Studies have been conducted in the Eastern Cape and Mpumalanga
Provinces relating to “out-of-pocket” expenditure when accessing health
care.
Poor inter-sectoral collaboration.
•
•
•
•
•
b
Inaccessibility of health services with regard to facility infrastructure,
signage and information in an appropriate medium, including sign
language and Braille. In addition, therapy is often not done in the client’s
first language.
Inadequate provision of appropriate assistive devices/technology and
accessories. Assistive devices ranging from walking aids to augmentative
and alternative communication devices should be available to clients
based on their needs. Devices such as the white cane have traditionally
been issued by the NGO sector and should now form part of services that
are available within government.
The lack of awareness, knowledge and training among healthcare
providers regarding the challenges, needs and rights of PWDs result in
poor care and disempowerment. Negative attitudes towards children and
adults with disabilities obstruct their participation in health and
rehabilitation services. Rehabilitation professionals are often not “culture
sensitive” and do not respect the value systems and beliefs of their clients,
which may delay early identification and intervention.
The paucity of appropriate rehabilitation indicators in the national and
provincial data sets impairs the quality and type of service, as there is no
proof of effective service delivery that could be used to motivate for
resources. There is little research linked to the outcomes of rehabilitation
services at secondary, tertiary and specialised levels, and none at PHC
level.
The core rehabilitation team should ideally comprise a physiotherapist,
occupational therapist, speech therapist, audiologist, medical orthotist and
prosthetist, and related mid-level health workers. The support team should
include a social worker, dietician, orientation and mobility instructor,
podiatrist, optometrist and psychologist. However, there is a lack of
equitable distribution and a high vacancy rate of service providers at the
different levels of care, especially rehabilitation staff at primary level (see
Table 1 below). In particular, junior rehabilitation professionals are often
unsupported and not trained to work with complex cases.
During January to April 2015 the Disability Policy Framework at the provincial
and local municipality level was under review and the following findings are
relevant to question.
SUMMARY OF TRENDS FROM MUNICIPAL REVIEWS
Awareness of and access to frameworks. Most municipalities knew of
frameworks, especially on disability and accessed them through websites,
meetings and the South African Local Government Association (SALGA).
Awareness of other national and international frameworks. Few municipalities
know of disability policies and relevant international conventions
Disability Institutional Frameworks. Most municipalities have integrated or
transversal programmes managed by a manager or unit, mostly located in the
Office the Mayor. These tend to work except that they always feel marginalized
and are treated as an 'add on'. There are external disability forums or
organizations in almost municipalities.
Disability Planning Frameworks. Disability is not always mainstreamed into the
core business of most municipalities through IDP. They are treated as ’add-on’
programmes with separate, albeit limited, budgets. There are not always specific
KPIs in the IDPs to consciously address disability issues.
3.1. Conditions of
accommodation
accessibility
and
the
provision
of
reasonable
a
Accessibility to social grants is determined by the definition of disability in the
Social Assistance Act, 2004, and qualifying criteria as outlined in the Social
Assistance Regulations of 2008. The assessment tools mentioned above have
a more inclusive definition of disability which, when implemented, will correct
inclusion and exclusion errors. The only reasonable accommodation considered
for social assistance is at pay points.
b
Universal access is encouraged at all levels in the Public Service. While some
departments are not including provision of reasonable accommodation when
preparing their budgets, those that are doing well in this regard are used as a
benchmark to assist the others.
c
The Accessibility Programme to ensure non-discrimination in terms of Chapter 2
of the Constitution, 1996, has been established in relation to access to stateowned buildings by PWDs.
3.2. Consideration of the specific needs of persons with disabilities within the
services and/or benefits of existing programmes
a
Social grants are provided as an income benefit for PWDs as a means of
alleviating poverty. The grants do not take the cost of disability into consideration.
b.
Disability mainstreaming is encouraged through integration into other
programmes and projects and departments are expected to report progress in
this regard.
c
The Accessibility Programme also ensures compliance with national building
regulations, the Occupational Health and Safety Act and SANS 10400 in terms
of universal access to government buildings, thus addressing the variety of
needs of PWDs and their mobility in government buildings.
3.3. Difficulties experienced by persons with disabilities and their families in
fulfilling requirements and/or conditions for accessing social protection
programmes
Beneficiaries of social protection programmes have the option to choose where
they want to receive their grants, either through dedicated pay points, banks,
post offices or retail shops. There are no challenges in terms of location.
Some of the difficulties experienced by PWDs are having the required
documentation to lodge applications for grants. This is specifically in relation to
availability of medical doctors to assess applicants for disability. When the
assessment tools are implemented, other health professionals will be included
for these assessments, thus reducing the waiting period.
3.4. Consideration of age, gender and race or ethnic-based differences and
possible barriers
Disability grants are provided to adults aged 18-59 years, which are converted
to Older Persons’ Grants at age 60 years, and Care Dependency Grants are
awarded to care givers of children with disabilities below 18 years. At the age of
18 an application for a Disability Grant must be lodged. Both grants are provided
regardless of gender, race or ethnic group.
3.5. Conflicts between the requirements and/or benefits of existing
programmes, and the exercise by persons with disabilities of rights such
as the enjoyment of legal capacity, living independently and being included
in the community, or work
Cabinet approved the 2% representation of persons with disabilities across all
levels and the MPSA is monitoring the achievement thereof and assisting
departments that are struggling.
3.6. Allocation of grants to personal budgets
Applicants for grants are subject to asset and means tests, which are adjusted
annually in line with inflation.
3.7. Disability-sensitive training and awareness-raising for civil servants and/or
external partners
a
The DPSA, in conjunction with the National School of Government, has
developed a Disability Management Programme for rollout in the Public Service.
b
DSD has embarked on nationwide training with SASSA on the Harmonised
Assessment Tool (HAT), which also includes disability sensitivity. The target was
7 000 but only 225 participants have been trained to date (2012/13 financial
year). The training could not continue as SASSA was busy with a re-registration
process. There are plans to continue with the training in the 2015/16 financial
year. DSD and the National School of Government are also developing Elearning for HAT. The plan for this financial year is to design and pilot the project;
if successful it will be rolled out in the 2016/17 financial year.
3.8. Existence of complaint or appeal mechanisms
Applicants can use the Internal Review Mechanism in SASSA, and Appeal
Mechanism in DSD if they are dissatisfied with the outcome of their application,
as provided in the Social Assistance Act, 2004, and Social Assistance
Regulations of 2008. Should there still be dissatisfaction applicants are free to
approach a court of law.
4.
PROVIDE ANY INFORMATION OR DATA AVAILABLE, DISAGGREGATED
BY IMPAIRMENT, SEX, AGE OR ETHNIC ORIGIN IF POSSIBLE, IN
RELATION TO:
a
Determining the prevalence of disability in South Africa remains
contentious due to the lack of agreement among stakeholders as to how
disability is defined. Present definitions are applied in terms of respective
legislation and different contexts, and focus primarily on impairment
without necessarily addressing the contexts in which barriers limit
participation. A major limitation is that disability prevalence surveys are
usually based on reported disability, often by a proxy informant, which
may overestimate or underestimate the prevalence.
According to a Statistics South Africa Report based on Census 2011 datai, the
national disability prevalence rate is 7,5% in South Africa. Disability is more
prevalent among females than males (8,3% and 6,5%, respectively).
The prevalence of a specific type of disability shows that 11% of people 5 years
and
older
have
visual
difficulties,
4,2%
cognitive
difficulties
(memory/concentrating), 3,6% hearing difficulties, and around 2%
communication, self-care and mobility difficulties.
Provinces with the highest reported disability were Free State and Northern Cape
(both 11,0%). Reported disability figures for the remaining provinces, in
descending order, are North West (10,0%), Eastern Cape (9,6%), KwaZulu-Natal
(8,4%), Mpumalanga (7,0%), Limpopo (6.9%), Western Cape (5,4%) and
Gauteng (5,3%).
Due to data limitations, the StatsSA prevalence rate excludes children under the
age of five and people with psychosocial and certain neurological disabilities.
The overall prevalence of childhood disability has been studied among smaller
target populations in South Africa over the past 30 years, but there are very few
recent data.ii Estimates of child disability prevalence generated from various
sources are not directly comparable as studies use different definitions of
disability and methods of data collection. Additionally, while the census and other
national household surveys include general questions about PWDs, these
questions are not specifically designed to identify children with disabilities.
According to StatsSAiii, South Africa’s population over 60 years is 7,8% and the
proportion of PWDs in the 60 to 69 year age group is 14,5%, rising to 34,7% in
the over-70 year group.iv
Population ageing is associated with impaired functioning and mobility
limitations, i.e. impaired vision, glaucoma, diabetic retinopathy, hearing loss, and
impaired mobility due to strokes, falls, bone and joint conditions.v -vi
The prevalence of Alzheimer’s and Parkinson’s disease and dementia in the
South African population is not known. A non-governmental organisation (NGO),
Dementia SA, recommends an urgent, targeted focus on dementia to determine
its prevalence and South Africa’s capacity to respond.vii
The constructive intention to decrease childhood mortality has had the
unintended consequence of increased childhood morbidity (disability), as is
evidenced by the number of children presenting with developmental delays and
cerebral palsy1. Much emphasis has been placed on reducing child mortality
rates, but the resultant increase in morbidity has been ignored. Chhagan and
Kauchaliviii advocate combining improved child survival with optimal development
into a single-outcome measure of “disability-free survival”.
The vicious cycle of poverty and ill-health is well known and in South Africa,
poverty has been recognised as one of the key causes of the continued high
burden of disease.
What is often inadequately understood in health service planning is the role of
disability in entrenching and exacerbating the cycle of ill-health and poverty.
Poor health outcomes frequently include residual functional impairments, which
result in loss of productive capacity, increased care and cost burdens on
households, and creation of additional barriers to healthcare access.
4.1. Coverage of social protection programmes by persons with disabilities
a
SASSA has statistics on social grant beneficiaries in terms of gender, age and
geographic location, but not according to impairment
* Grants are accessible to all people who meet the eligibility criteria in all nine
provinces in the country.
b
The Extended Public Works Programme has a target of 2% to create job
opportunities for PWDs.
4.2. Rates of poverty among persons with disabilities
Latest statistics of beneficiaries are as follows (September 2014)
•
•
Disability Grants: 1 120 772
Care Dependency Grant: 134 456
* Additional information can be found at Prevalence of Disability in South Africa,
Census 2011 http://www.statssa.gov.za/?p=3180
4.3. Additional costs or expenses related to disability
A research study was commissioned to determine additional costs incurred by
PWDs compared to persons without a disability. The process is still in a first
phase and the study report will be released after obtaining Ministerial approval.
5.
PROVIDE INFORMATION IN RELATION TO THE ELIGIBILITY CRITERIA
USED FOR ACCESSING MAINSTREAM AND/OR SPECIFIC SOCIAL
PROTECTION PROGRAMMES WITH REGARD TO PERSONS WITH
DISABILITIES, INCLUDING:
5.1. Definition of disability and disability assessments used for eligibility
determination
Disability grant definition: Social Assistance Act, 2004, (section 9) reads as
follows: “a person has physical or mental disability, the person is unfit to obtain
by virtue of service, employment or profession the means needed to enable
him/her to provide for his/her maintenance”.
The definition of a Care Dependant child: Social Assistance Act, 2004, (section
7) a care dependent child is “a child who requires and receives permanent care
or support services because of his or her physical or mental disability”.
5.2. Consistency of the eligibility criteria among different social protection
programme
Eligibility Criteria for Disability Grants (Social Assistance Regulations, 2008):
•
•
•
•
•
The applicant must be 18 years and older (18-59)
The applicant must be a South African citizen, permanent resident or
refugee with refugee status
Must have a disability
Must qualify in terms of the definition
Must pass the means test
Eligibility Criteria for Care Dependency Grant (Social Assistance Regulations,
2008):
•
•
A parent, primary caregiver or foster parent must be a South African
citizen, permanent resident or refugee with refugee status.
Child must be 0-18 years.
•
•
•
•
Child requires and receives permanent care and support services due to
his/her physical or mental disability.
Child must not be cared for on a 24-hour basis for > 6 months in an
institution funded by the state.
Disability must be confirmed by a medical doctor through an assessment.
Applicant and child must meet financial criteria set in the Regulations.
NB: Both definitions are expanded for the use of assessment tools mentioned
earlier.
5.3. Use of income and/or poverty thresholds
Disability grants:
Income Thresholds
Single: R64 680
Married: R129 360
Asset Thresholds
Single: R930 600
Married: R1 861 200
Care Dependency Grant:
Income Thresholds (of primary care giver)
Single: R169 200
Married: R338 400
5.4. Consideration of disability-related extra costs in means-tested thresholds
[Query: no information?]
REPUBLIC OF SOUTH AFRICA
i.
Statistics South Africa. Census 2011: Profile of persons with disabilities in South Africa
Report No. 03-01-59. Pretoria: Statistics South Africa; 2014.
ii.
Department of Social Development (DSD), Department of Women, Children and
People with Disabilities (DWCPD) and United Nations Children’s Fund (UNICEF).
Children with disabilities in South Africa: A Situation Analysis 2001–2011. Pretoria:
DSD, DWCPD and UNICEF; 2012.
iii.
Statistics South Africa. Mid-year Population Estimates Report. Pretoria: Statistics South
Africa; 2013.
iv.
Statistics South Africa. Social Profile Report. Pretoria: Statistics South Africa; 2009.
v.
Joubert J, Bradshaw D. Population ageing and its health challenges in South Africa. In:
Steyn K, Fourie J, Temple N, editors. Chronic diseases of lifestyle in South Africa 19952005. Tygerberg: South African Medical Research Council; 2006/2005.
vi.
Joubert J, Bradshaw D. Health of older persons. In: Ijumba P, Day C and Ntuli A,
editors. South African Health Review 2003/4. Durban: Health Systems Trust; 2004.
p147-162.
vii.
Dementia SA. Dementia, the invisible disability. What are we up against? The DG
Murray Trust Hands-on Learning Brief 73 2014, Dec; Cape Town:1-3
viii.
Chhagan MK, Kauchali S. Child development and developmental disability. Paper
presented at Developmental Disabilities Research Collaborative (DDRC) between the
University of KwaZulu-Natal (UKZN), Department of Health, Department of Education
and Department of Social Development. 28 March 2011. Durban: University of
KwaZulu-Natal.